Request a Modified or Custom Cable

First Name *

Last Name *

Title *

Company *

Email *

Phone *

Street Address *

Address Line 2

City *

State / Province / Region *
Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific

ZIP / Postal Code *

Comparable Item Spec

If this item exists in the market, please list any info you have on it here, including web links to more info, brand name, and/or part numbers.

New Item Spec

Please list the technical product specifications for the item you are requesting.

Quantity *

List the quantity and the usage rate associated with the quantity (one-time buy, annual usage, etc.).

Price Desired

Price Desired

Price Desired *

Packaging *

Spool, Reel-in-a-Box, Pull-box, etc.

Branding

Branding *
RemeeOEM/Private LabelGeneric

Cable Jacket Rating(s) *

CMR, CMP, FPLR, FPLP, CL3P, etc.

Certification *

ETL, cETL, CE, etc.

Ship Date Needed *

Additional Details

Please provide any other information that may be helpful.

File Attachments

Please attach any files that may be helpful.